Adil Mohammad, Amin Syed Suhail, Mohtashim Mohd
Department of Dermatology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
Indian J Dermatol Venereol Leprol. 2018 Nov-Dec;84(6):652-659. doi: 10.4103/ijdvl.IJDVL_33_18.
N-acetylcysteine is a mucolytic drug which is commonly used as an antidote for acetaminophen toxicity. It is a thiol compound, which acts as a donor of cysteine, leading to replenishment of glutathione and thus acts as an antioxidant. It also has anti-inflammatory effects, alters the levels of neurotransmitters, inhibits proliferation of fibroblasts and keratinocytes and causes vasodilatation. Due to these actions, n-acetylcysteine has found use in several dermatologic conditions in systemic and topical form. The drug has been used as an adjuvant in the management of conditions such as toxic epidermal necrolysis, drug hypersensitivity syndrome, trichotillomania, skin picking disorders and onychotillomania, ichthyoses, contact dermatitis, atopic dermatitis, melasma, pseudoporphyria, connective tissue diseases, wound healing and alopecia. It also has a role in protection from radiation-induced skin damage including photo-ageing, photocarcinogenesis and radiation dermatitis. Most indications in dermatology are supported by case reports, small case series and small trials. Higher quality of evidence is needed for its wider use. The drug is cheap and is generally safe with few adverse effects. Thus a greater role is possible for use of n-acetylcysteine in various skin conditions. This review explores the various uses of n-acetylcysteine in the field of dermatology, the evidence supporting the same, the possible mechanisms of action and the adverse effects of the drug.
N-乙酰半胱氨酸是一种黏液溶解剂，常用于对乙酰氨基酚中毒的解毒治疗。它是一种硫醇化合物，可作为半胱氨酸的供体，从而补充谷胱甘肽，起到抗氧化剂的作用。它还具有抗炎作用，可改变神经递质水平，抑制成纤维细胞和角质形成细胞的增殖，并引起血管扩张。由于这些作用，N-乙酰半胱氨酸已被用于多种全身性和局部性皮肤病的治疗。该药物已被用作辅助治疗药物，用于治疗中毒性表皮坏死松解症、药物超敏反应综合征、拔毛癖、皮肤搔抓障碍和拔甲癖、鱼鳞病、接触性皮炎、特应性皮炎、黄褐斑、假性卟啉症、结缔组织病、伤口愈合和脱发等疾病。它在预防辐射引起的皮肤损伤方面也有作用，包括光老化、光致癌作用和放射性皮炎。皮肤科的大多数适应证都有病例报告、小病例系列和小型试验的支持。为了更广泛地应用该药物，还需要更高质量的证据。该药物价格便宜，一般安全，副作用少。因此，N-乙酰半胱氨酸在各种皮肤疾病中的应用可能会发挥更大的作用。这篇综述探讨了N-乙酰半胱氨酸在皮肤科领域的各种用途、支持这些用途的证据、可能的作用机制以及该药物的不良反应。
